American Journal of Physical Medicine & Rehabilitation · 2021 · 66 citations · 37 references
MedicineInfectious DiseasesPediatricsPediatric Infectious DiseasesPediatric NeurologyPediatric Rehabilitation MedicinePediatric Neurologic DisordersPediatric NeuropsychologyDivided Auditory AttentionLong CovidLong-term Neurocognitive SequelaeLong-term Neurologic SequelaeMultidisciplinary Rehabilitation ModelsPersistent SymptomsSars-cov-2 InfectionSustained Auditory Attention
ABSTRACT: The long-term sequelae after SARS-CoV-2 infections in children is unknown. Guidance is needed on helpful models of care for an emerging subset of pediatric patients with postacute/long COVID who continue to experience persistent symptoms after initial COVID-19 diagnosis. Here, we describe a pediatric multidisciplinary post-COVID-19 rehabilitation clinic model as well as a case series of the initial cohort of patients who presented to this clinic. A consecutive sample of nine patients (pediatric patients <21 yrs of age) who presented to our clinic are included. The most common presenting symptoms were fatigue (8 of 9 patients), headaches (6 of 9), difficulty with schoolwork (6 of 8), "brain fog" (4 of 9), and dizziness/lightheadedness (4 of 9). Most patients had decreased scores on self-reported quality-of-life measures compared with healthy controls. In the patients who participated in neuropsychological testing, a subset demonstrated difficulties with sustained auditory attention and divided attention; however, most of these patients had preexisting attention and/or mood concerns. There were also some who self-reported elevated depression and anxiety symptoms. Pediatric patients with postacute/long COVID may present with a variety of physical, cognitive, and mood symptoms. We present a model of care to address these symptoms through a multidisciplinary rehabilitation approach.
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